Bottom Line:
Symptoms regression and quality of life improvement were observed in all the cases.No complications were observed and all the patients were discharged within 12 hours after the procedure.Abstract available from the publisher.

Objective: The present article is aimed at reporting the author's experience with transcatheter arterial embolization using a lipiodol-ethanol mixture in three cases of unresectable symptomatic giant hepatic hemangiomas.

Materials and methods: The cases of three patients with giant unresectable symptomatic hepatic hemangiomas embolized in the period 2009-2010 were retrospectively reviewed. In all the cases, transarterial embolization was performed with an ethanol-lipiodol mixture.

Results: Symptoms regression and quality of life improvement were observed in all the cases. No complications were observed and all the patients were discharged within 12 hours after the procedure.

Conclusion: Transcatheter arterial embolization using ethanol mixed with lipiodol was a safe and effective treatment for symptomatic giant hepatic hemangiomas in this small series of patients.

f01: A: Coronal, T2-weighted MR image showing extension of the gianthemangioma into the thorax (asterisk) and displacement of the heart (arrowhead) aswell as of normal liver parenchyma (arrows). B: Axialpost-gadolinium- enhanced MR image showing the typical pattern of hemangioma.C: Late venous phase of digital subtraction arteriogram showingdisplacement of the portal vein (arrow) to the left and no portal venousenhancement characterizing hemangioma (asterisk). D: Digitalsubtraction arteriogram image of right hepatic artery showing a diffuse nodularpattern of hemangioma.

Mentions:
All the nodules showed the typical pattern of hemangiomas at contrast-enhanced computedtomography (CT) and/or magnetic resonance imaging (MRI). No biopsies were performed. Allthe patients were considered to be high-risk cases and were ineligible for major hepaticresection, because of involvement of multiple segments and/or extensive contact of thetumor with major vessels (Figure 1).

f01: A: Coronal, T2-weighted MR image showing extension of the gianthemangioma into the thorax (asterisk) and displacement of the heart (arrowhead) aswell as of normal liver parenchyma (arrows). B: Axialpost-gadolinium- enhanced MR image showing the typical pattern of hemangioma.C: Late venous phase of digital subtraction arteriogram showingdisplacement of the portal vein (arrow) to the left and no portal venousenhancement characterizing hemangioma (asterisk). D: Digitalsubtraction arteriogram image of right hepatic artery showing a diffuse nodularpattern of hemangioma.

Mentions:
All the nodules showed the typical pattern of hemangiomas at contrast-enhanced computedtomography (CT) and/or magnetic resonance imaging (MRI). No biopsies were performed. Allthe patients were considered to be high-risk cases and were ineligible for major hepaticresection, because of involvement of multiple segments and/or extensive contact of thetumor with major vessels (Figure 1).

Bottom Line:
Symptoms regression and quality of life improvement were observed in all the cases.No complications were observed and all the patients were discharged within 12 hours after the procedure.Abstract available from the publisher.

Objective: The present article is aimed at reporting the author's experience with transcatheter arterial embolization using a lipiodol-ethanol mixture in three cases of unresectable symptomatic giant hepatic hemangiomas.

Materials and methods: The cases of three patients with giant unresectable symptomatic hepatic hemangiomas embolized in the period 2009-2010 were retrospectively reviewed. In all the cases, transarterial embolization was performed with an ethanol-lipiodol mixture.

Results: Symptoms regression and quality of life improvement were observed in all the cases. No complications were observed and all the patients were discharged within 12 hours after the procedure.

Conclusion: Transcatheter arterial embolization using ethanol mixed with lipiodol was a safe and effective treatment for symptomatic giant hepatic hemangiomas in this small series of patients.